Introduction: Sacubitril/valsartan (sac/val) is a new treatment option for patients with heart failure and reduced ejection fraction. Limited data exist regarding its use outside of clinical trials, especially for prescribed dosages. This non-interventional database study aimed to describe dosing patterns and evolution of clinical parameters of patients who were prescribed sac/val in primary care practice (PCP) or cardiology practice (CP) in Germany.Methods: Data from 1108 PCP and 41 CP from the German IMS Disease Analyzer database, which includes electronic medical records from a representative panel of >3100 physicians, were used to identify patients. The study period was from 01/01/2016 to 31/12/2016, with a look-back period to 01/01/2015. Patients (≥18 years) with a sac/val prescription (Rx) during the study period were included; date of the first Rx was defined as index date. Linear mixed-effects models were used to estimate the evolution of clinical parameters before and after first sac/val Rx.Results: The study population comprised 1643 patients (1041 from PCP; 602 from CP). A subset of patients in the PCP (ranging from 119 to 338) had evaluable data (at least one value within 12 months before and after Rx of sac/val) for NT-proBNP, NYHA class, HbA1c or blood pressure (BP). The majority of patients in PCP (63%) had their first Rx of sac/val at the lowest dose of 24/26 mg BID. Most Rx during follow-up were issued for the lowest dose (51%); 35% for the intermediate dose of 49/51 mg BID and 14% for the highest dose of 97/103 BID. Similar results were observed in CP. Evaluation of clinical parameters before and after Rx of sac/val showed an average decrease in NT-proBNP levels by -503 pmol/L (95% CI: -789, -218), p<0.001; HbA1c levels by -0.11 % (95% CI: -0.20, -0.01), p<0.05; systolic BP by -3.37 mmHg (95% CI: -4.73, -2.00), p<0.001; diastolic BP by -1.63 mmHg (95% CI: -2.50, -0.76), p<0.001; and a shift in the NYHA class towards less severe symptoms (p>0.05).Conclusions: Patients prescribed sac/val were more likely to receive the lowest dose irrespective of the clinical setting (PCP/CP). Changes in clinical parameters before and after sac/val Rx mirrored findings from PARADIGM-HF study. These data suggest more education on sac/val up-titration is needed.